My cardiologist is concerned that having 12 hour episodes of afib every 12 days will restructure (damage) my heart. My EP does not seem that worried, however.
Apparently, statistically, I can expect to lose 2.6 years off of my life expectancy, which seems a bit paradoxical, because if I expect to lose 2.6 years then that is my life expectancy...
I know it means had I not had Afib, but I still find such statistics pretty meaningless.
I just wanted to know what others have been told.
Thanks,
Fibnum
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I have always been told that provided rate is well controlled (ie kept under 100-110) during events and anticoagulation taken where appropriate there is no loss of life expectancy.
Thanks, Bob, I take a small dose of metoprolol daily (25 mg), and I do not usually go over 100 initially, and my heart slows down soon. BP tends to be fine throughout the 12 hours, more or less, that I am in Afib. I think each case has to be considered based on the individual's Afib symptoms and response, thanks for seconding that. Maybe I will only lose a couple of weeks!
Not strictly true, although the usual consensus is that the Atrial Fibrillation alone won’t necessarily foreshorten your life. We are all individuals and the effects of Atrial Fibrillation can be widely different for each person. Long term permanent Atrial Fibrillation can cause Bi(left & right) Atrial enlargement which can result in Mitral Regurgitation and Tricuspid Regurgitation which could require surgical intervention for repair or replacement. This impacts on the performance of the heart and can influence long term prognosis and life expectancy. This is a direct result of the ‘quivering’ of the atria in Atrial Fibrillation even though rate maybe controlled. It is not possible to get an absolute rate when in Atrial Fibrillation even with control medication because it fluctuates continuously with the erratic beating of the atria. Atrial Fibrillation is not a ‘one fits all condition’ but rate control and living your life fully day by day is so very important.
Very good! They are both standard abbreviations like AF, CHD, PAF etc, and I’m too old now to do everything longhand. The gist of my comments contained the relevance.
Wow DoodyToot you have certainly educated me with your reply to BobD. 100% I fit your interpretation. 18 March I am under going open heart surgery for Mitral Regugitation, Tricuspid Regurgitation and maze procedure to treat afib.
As for performance of heart I have been in constant afib 24/7 for 10 months. Before that I had episodes of afib since 2020 which got much worse with severe tachycardia lots of admissions to hospital. Finally told I could not be given any meds because I was too sensitive to them. Only treatment given now since being in constant afib for so long is 2.5 biosoprol and apixaban. After surgery, if I pull through an sure my life expectancy will be reduced.
By the way NHS is not doing surgery, I had to get it done private. So far cost 60'000 price could be more depending on any complication and length of recovery time.
Thanks for educating me DoodyToot
I had to sell my home to cover cost of private procedure....far to long waiting list on NHS causing heart to deteriorate even more.
I wish you good luck with your surgery tomorrow, and this option, which I presume is a sternotomy is the gold standard for 'end to end' repair. The other options of catheter and minimally invasive repair cannot perform mini maze to try and convert your heart back to NSR. It seems that your current medication should help to at least control rate and reduce the risk of embolism. It may also be beneficial if the surgery also occulted the left appendage and which would also reduce the future risk of stroke. You have made a significant commitment in selling your house to fund this procedure, and to give yourself the chance of a better quality of life. It is a shame that the NHS waiting lists are extensive for this type of procedure, unless it is non elective surgery and part of a CABG(coronary artery bypass graft for those who don't like abbreviations). My thoughts will be with you tomorrow, and I wish you well for a good, healthy and long life.
Sincere thanks DT. I had a stroke April last year (brain clot) due to afib which has effected my mental comprehension an memory, feel like I got dementia. Anyway you mentioned if the surgeon also occulted the left appendage this would reduce the risk of future stroke. Is there an actual medical name for this procedure so I can ask surgeon if he is doing this during surgery?
My surgery is Wed 19 March.
Here is a list of procedures mentioned on my bill:
1 Replacement or repair of mitral valve. Device Perimount Magna Ease
Really would appreciate a reply. Prior to stroke I would have researched these procedures myself but can't do that any more cos I literally cannot comprehend the info at all.
LAAO(Left-atrial appendage occlusion) It sounds like your Surgeon has a really good idea of the procedures that you may require, and they have most likely undertaken an Echocardiagram and possibly a TOE(Transoesophageal echocardiogram for those who don’t like abbreviations) which will give very detailed imaging of the condition of the valves and structure of the heart. Repair is usually feasible if the valve is functioning but there is regurgitation through the ring. If it is diseased through say calcium spot deposits then it may need to be replaced with either a mechanical or animal tissue valve. Trust in your surgeon, cardiologist, medical team and the hospital/clinic where you are undergoing these procedures. All the very best.
Statistics like the one you mentioned are usually accurate when applied to a whole population. They generally cannot identify those individuals within the population who will succumb to the outcome. There are too many confounding factors. The longer you live, the longer you are going to live. A brief look at a life expectancy chart and a bell curve will confirm this. That said, I recently read that AI can accurately and consistently identify life expectancy to within a month if sufficient personal information is submitted.
I live in ‘sheltered housing’ which consists of a block of flats with a manager, an emergency call system, a general heating system, supermarket next door etc.It’s very sociable as well and I’m sure that also helps but I have noticed the building is mostly full of people over eighty and several around 90, all of us living more or less independently. But I think part of our longevity is down to just having got to 80 in reasonable health in the first place, it seems that with reasonable care such people go on and on! I hope…..
I have not been told anything and quite honestly l wouldn’t want to know or be interested.
I think us A Fibbers should take everyday as it comes, take the treatments that are available, live life to the full, as much as we can and, be grateful that we don’t have a terminal illness. Life is short anyway, we don’t have control over our destiny so why worry about it. Think of nice things.
I concur, and that is the approach I have taken. One issue, though, is whether the real likelihood of heart damage is sufficient to warrant undergoing an ablation. I have held off because the afib has not harmed my quality of life to a significant degree.
I know we can't always know what choice is best, but I appreciate the responses!
I am in exactly the same position. I have held off ablation because, to date, my quality of life is ok. I have had 7 years of paroxysmal AF and my heart is structurally sound. The decisions we have to make can be difficult, but no one knows your body like yourself. With AF there are no comparisons because of the diversity and complexity of the condition.
One also has to take into consideration age, l am 77 and what life l have left l want to enjoy some peace from this. Thankfully l am able to do this at present. I don’t want to spend the rest of my life shooting in the dark. What’s to be will be. There are far worse illnesses to have.
I too was holding off an ablation, until I found the AF load increasing and I finally agreed to one. I had a rough ride afterwards, but it eventually settled down and I now only occasionally have a recurrence. I take that view that an ablation "damages the heart" by definition, as will AF eventually, so it's a matter of balancing two evils.
Thanks for sharing your experience. It seems to me like between a rock and a hard place. I have other health problems with stomach issues. The procedure of ablation is close to the esophagus. I also have reservations with GA.
I probably will have to have surgical intervention at some point, especially if AF progresses and destroys my quality of life. At the moment, l don’t feel l want to be back and forth to hospital for the rest of my life. Ablations are not a cure and the thought of having to have more than one doesn’t appeal. At this moment in time l need some peace from hospital appointments.
Thanks for your encouragement and glad your treatment was a success. I wish you well.
Frankly, I don't think anyone has a definitive answer whether 12 hour episodes of atrial fibrillation every 12 days can hurt your heart or shorten your life expectancy.
Are these asymptomatic epidodes with a normal heart rate, or do you have symptoms with an elevated heart rate? Because if the latter, it begs the question, why are you getting 12 hour episodes of atrial fibrillation every 12 days when there are strategies, pharmacological, or surgical to prevent that.
I think what is asked is are you symptomatic - i.e. are you aware of the arrhythmia, do you feel it, or asymptomatic i.e. are you unaware of it but know because you have a device like an Apple watch that records your episodes?
Symptomatic AFib is hard to live with. Asymptomatic isn't.
Yes, I agree I am a bit confused. I have read regular AF can remodel the heart (leading to heart failure) and common sense tells me also that a weak rapid heartbeat will not be good for circulation & general body maintenance.
However others including my cardiologist don't seem to flag that up focussing instead on whether the AF is psymtomatic or not as a determinant on whether to go for an ablation.
Is this another case of the many faces of AF and individual medics sticking to their own interpretation as there is no recognised one way?
Based on my discussions with my cardiologist and EP - and remembering I have more issues with other arrhythmias than AF alone - the main purpose of all of the medications and treatments I take is to prevent structural damage to my heart. That’s is the number 1 priority.
I’m not sure of how correct the statistics are and as others have said, statistics are not individual, but I do think that preventing structural damage to the heart helps with longevity. It makes sense to me. Even harmless ectopics can cause damage if they’re high enough in number and frequency.
Exactly. It was the correct route for you. We take whatever treatment we need and what is best for us personally, at that moment in time, to give us the best quality of life possible. It was necessary for you. Good to hear you are well. Take care.
I was in uncontrolled AF for 20 years (10 years persistent...it started in my late 20s) until aggressive treatment, couple years ago, and now in NSR. Lots of that time though my heart was over 100.There was heart remodelling and I did hit the heart failure category a few years back, but now back in NSR, I am back out of that category.
My point being that I think people worry about doing permanent damage (understandably) but it takes quite a bit I think to actually remodel the heart. Not a few episodes.
I think the narrative around AF being just a nuisance condition is really unhelpful, as it clearly can cause a lot of harm, but equally it doesn't help to live in fear of it.
I am pretty sure given the damage to my heart there will be a few years knocked off. I have a few other health conditions that probably do the same. And some of them are already debilitating and life impacting if not life shortening. So, I tend to do what I can when I can. And parallel "plan" for all eventualities in terms of work, pension, finances etc without getting hung up on that or assuming anything is a given. Way too many variables! 😊
I take Vit C tabs daily..think Dr Gupta (york cardiologist on YouTube) mentioned that it helped repair the heart muscle in rats…..well.it won’t hurt to do it, don’t know how my heart looks inside from the first and only echo 3 yrs ago when diagnosed.
I haven’t been told anything except that it was important not to be in AF over 100 for any length of time. I also think - just my own observation - that the irregularity of AF plays a part as mine usually starts quite fast and very irregular and then smooths out over time if I don’t aggravate it until I can barely notice it. But slow and very irregular is also debilitating so there are definitely different ’makes and models’ of AF and your particular one affects your personal outcome.
AF caused my heart and left atrium to enlarge which has now resulted in my being on a list for mitral valve repair surgery. The enlargement of the atrium has pulled the annulus (framework) around the valve out of shape and consequently, the valve doesn't close properly.I was in AF pretty much permanently and very symptomatic bit it's currently controlled by Amiodarone. Being back in NSR has not caused the heart to shrink back although, apparently it can sometimes. The AF sometimes isn't the problem but it causes them.
My permanent AF has caused my heart to enlarge. On my last Echo it said:left atrium moderately dilated. Right atrium moderate to severely dilated. Mild mitral regurgitation but opens well. Ejection fraction =>55%. The cardiologist says my heart is structurally fine. When I saw an EP 2 years ago he suggested Amiodarone, then cardioversion with potentially an ablation. I haven't gone down that route because of my fear of the side effects of Amiodarone so I am living with symptomatic AF treated only by beta blockers; BP meds and Eliquis. The EP said "AF won't kill you but it will impair your quality of life". Can you tell me how you got on with Amiodarone please. Especially conversion to NSR. Did that happen with Amiodarone alone or a cardioversion and or ablation.
Hi. I've been on and off Amiodarone, latest stint may be 4 years. I have had no major issues that I'm aware of. I have some vortex keratopathy which has caused corneal deposits, which they say should go when the Amiodarone is stopped.
I had ablation in 2021 but that failed quite quickly.
I have had several cardioversions, lasting up to 2 years and certainly, the Amiodarone has helped woth that.
I'm have an echo next month as its been about 3 years since the last. I've got severe MVR but my EF last time was 65%, I believe.
They are supposed to be doing a Cox IV Maze at the same time as the valve repair, to hopefully stop the AF once and for all as there's supposed to be about a 90%+ success rate.
Surgeon also mentioned reducing the size of the atrium/heart at the same time....... a sort of heart tuck. I did ask him if he could do a tummy one at the same time but I'm not sure he had much of a sense of humour. 😁
Thank you Ducky2003. It is heartening to hear that Amiodarone with cardioversion has potentially given you a couple of years of NSR. I haven't heard of an atrium tuck but I will remember to ask about the tummy. After all there is some speculation that AF can be stimulated via the gut! Do you think I'll get away with that argument?
I fortunately get infrequent short bouts of AF. I read about fast and slow AF, but I find when mine starts (do not have any special equipment) - It's when I've got myself into a quite unnecessary stressed state, apart from my BP monitors, I have a finger Pulse Oximeter which if I put it on shows my HR jumping around between say 40 BPM and 150 BPM - I take 1.25mg Biso and it gradually comes down from the high point and increases from the low point, until it become a steady 70 BPM or so. The whole episode takes lasts about 4 hours. Should it happen like this, is it fast or slow AF? I apologise for asking this question on this thread, maybe I should have started my own. Please ignore if inappropriate.
I usually start around 80-100 but slow down within a half hour to 60-80. The pulse is so erratic the monitor measuring doesn't mean much. I think the low dose daily metoprolol helps avoid extreme racing when I get afib.
Thanks - I find if think my HR is fast, it's a strange feeling ! and it's gone up into the 90s and I take 1.25mg of Biso, it stops it from going into fibrillation. I am on an as needed regimen with the BB, as I don't like the side rffects - I think I'll ask my Cardiologist for a different one that i can take a very low dose of daily without feeling like something out of a horror film !
one of the first things my EP told me to do was get rid of the oximeteretc. stop checking that I will make myself crazy and yes, you’re supposed to have that Take a look at an athlete before he runs a marathon and then check it will see what happens if it doesn’t go back down then you’ve got an issue. It is supposed to reflect how busy or what you are doing to show that your heart is pumping and things are going well I’m usually in the 60s when I get up by the time I come in taking the dog out for the first time it could be in the 90s and then usually settle down to about 72 if I get stressed aggravated whatever I can watch it shoot right back up without moving
now that I have a pacemaker, the main thing I had to learn that they forgot to tell me was I still can get the feeling of flutter I have a typical. My a fib does not seem to act up anymore, but my flutter can the difference is with the AV node done it no longer my around and they are being annoying. I have been fighting some type of illness and it really decided to act and stay fluttering. It was nice to be able to relax and not be scared of it because I know just doing it all by itself like a nasty person having a temper tantrum. what I think of flutter a I share that with people to make you laugh. We are stuck with it. It does what it wants. If you don’t have a pacemaker you really need to it. Avoid your triggers. Don’t stress yourself over nothing like an oximeter. There are many different things you can do just be smart and it will be easier on you.
we don’t know how many years we have anyway I wouldn’t worry about what he said.
Bob is right listen to him. I have heart failure because I had six months of steady tachycardia and I’ve had tachycardia since the beginning of a fib so that definitely was going to do me in which is why I had to get the pacemaker. FYI, after I got the pacemaker, my ejection rate has gone from in the 40s to the 70s because there is not still being done. The damage was the tachycardia close to 200 my heart and I were exhausted.
I don’t worry about stuff like this because I could step out the door and get hit by a bus. If you’re gonna worry about it, you’re not gonna be enjoying life very much.
I don’t know why doctors aren’t more careful with what they say or how they say it sometimes they forget we are people and we don’t know what they do. It’s like talking to someone who is having part of the conversation in their head. They don’t say all of it so you’re only getting what they are telling you and it’s not the whole story.
Such statistics can seem meaningless when not taken within the context they were intended for, and sometimes such statistics are based on evidence that might be questionable. An elderly friend is nearly 92 and has had permanent AF (at a lowish rate) for many years. He remains well.
Aside from the increase in clotting that AF causes, the issues around it, so far as I know, are what, if anything, it is doing to the ventricles (for example, speeding them up too much and for too long. risking weakening them). Also, AF in a heart that has any other issues with the ventricles, such as any kind of heart block or whatever. Some people's AF drops their heart output too far, too, which makes them very symptomatic. That might not affect the heart, even over the long term, but it might not be easy to cope with.
I think the differing views of your doctors reflect no more than the lack of certainty concerning prognosis. AF can be a product of an ageing heart and a none-too-healthy lifestyle so producing statistics must be very difficult given the many confounding factors at play.
just looking at your message again so what is your Cardiologist plan to do about it if he’s so concerned? I would say follow the lead of your EP if he’s a good one I’m starting to lose faith when it comes to my just remember they are the plumbers EP is the specialist when it comes to a you really feel unhappy with get a second opinion. I just recently had something with my that made me see he just doesn’t know what he doesn’t know when it comes to things like my pacemaker. If they were all that good, they wouldn’t need an EP.
relax because the anxiety will make you feel bad sometimes we listen to too many people and you know what they say about too many cooks in the kitchen
I have been told the same but my out look is this- No two people are the same. We are trying the best we can to mange this concern and to me these statistics are arbitrary at best. I go home when I go and Im okay with it. I don’t encourage death, rather embrace it. Just my opinion.
statistics DO NOT apply to individual cases…such numbers are derived from population samples, frequently small samples. Your EP has the right attitude!
I wouldn't pay any attention to stats like that. We probably lose more time than that waiting for buses, trains, telephone queues and filling in forms!
If a few years are taken from your life due to a condition like AF, but you’re able to live well and maintain some function, you’re lucky. If the alternative is years of severe, poor health or progressing dementia, then perhaps having those years taken off isn't so bad. Quality of life as they say is important.
I have persistent afib and often spend months in afib. When I’m in afib I take beta blockers and my heart rate in afib is in the 60s. The only way I can get out of afib is a cardioversion and they don’t typically last long. I have yearly echocardiograms and my heart is fine. Both my EP and cardiologist aren’t concerned about heart damage at this point. I’m waiting for an ablation.
my goodness 12 hours every 12 days a lot myself I would look into a second opinion with an EP. I had very few episodes although my heart rate was at 35-40 so I needed a pacemaker so they could treat my Afib and . currently I am on 75 mg of flecainide in the morning and at night to control Afib.
I’ve changed my whole diet up. I’m walking every day. I’m hoping to reduce the amount of Flecainide to 50 mg two times a day. We’ll see I see EP on the 21st of this month.
I’m so sorry you’re having to go through this Afib robs you of your life. Life starts living you. You don’t get to live life.
I am not sitting around worrying about it. I just wanted to know what people are being told concerning afib's effect on heart health. From time with family, exercising, shopping, classical concerts, church and writing amateur poems, I am very lucky and not that worried about afib. I would not mind if the bloody stuff went away, though!
I think I gave the erroneous impression that I am too preoccupied with it.
Some commenters online have fixed their infrequent afib just by taking magnesium glycinate. Watch Dr. Gupta's videos as someone said above. Mine is not as often as yours, but comes and goes. Seems to be mostly stress, but Magnesium is supposed to be good for stress. I am currently taking an extra 100mg elemental over the normal suggested amount on the bottle when I feel stressed, so far so good for a few weeks. Anyone else trying this?
OK, good. Here in USA, if you have been in afib more than 24 hours they will not electrically cardiovert you because of the risk of dislodging a clot from the Left Atrial Appendage. So, at 12 hours, you "should not" have that risk. I am usually out of Afib by then too, but a couple of 24 hr episodes. Felix Harder on YouTube talks about electrolyte balancing. I am trying to use his advice with blood tests instead of the hair tests he recommended. I cut back on calcium, added some Potassium Chloride powder, and limit my salt(sodium), and of course Magnesium. There are other things too: fix your sleep apnea/snoring(Xlear nasal spray helped a lot, as did more water during the day, and a thicker pillow), walk, reduce stress, fix GERD(Betaine salts worked) and on and on. I am hoping to not need an ablation, but we will see.
I ended up with heart failure, but that’s because I had tachycardia and an extended period of six months of it. That’s how I ended up with my pacemaker to stop the damage by having my AV node, etc., are done. I’m curious to show have a book of dates when we expire like milk. Not everyone with a fib. Get a pacemaker and even they are not a guarantee although the best thing I have found for my situation. We are all different. If you know tachycardia is then you realize what’s going on and why you get damage. If your heart is out of sync enough to be called a fib. It doesn’t necessarily mean you’re gonna have all that going on unless I’m wrong and I’m not an expert so someone will probably speak up.
if we don’t know how long we have anyway how can they tell us how much we are going to lose off of our life?
I’m glad you thought the way you did that’s how I think too much doom and gloom sometimes out there. Both of my family had a variety of heart issues and yet most of them made it their 90s. I had an uncle that made it to 102.
best of luck I do hope the EPpays better attention when you say every 12 days you have an episode of 12 hours why doesn’t he check to see and compare a few months of this to see things like rate? My situation was very different and my EP please tell me you have an anticoagulant lol I am the anticoagulant checker. I want to see everyone’s do the best they can.
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Not me! I'm ouranos bound.. 
Afib and heart failure 
New to Afib from Canada
Struggling with my anxiety over Afib
Afib isn't a disease,it's a malady 
